Individual provider Active NPI

Ing Erik Swenson, LCSW, CRADC

  • Social Worker
  • Chicago, IL
National Provider Identifier
1063680650
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
149.017451 Issued in IL
Practice address
3656 N Halsted St
Chicago, IL 60613-5974
Phone
(773) 472-6469
NPI assigned
Feb 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CA
Mental Health Counselor 101YM0800X LW00009364 WA
Clinical Social Worker 1041C0700X LCS 28549 CA
Social Worker 104100000X 149.017451 IL Primary

Addresses

Primary practice location

3656 N Halsted St
Chicago, IL 60613-5974

Mailing address

3656 N Halsted St
Chicago, IL 60613-5974
Phone (773) 472-6469

Other practice location 1

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002413 IL Practitioner - Clinical Social Worker 8628152600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3656 N Halsted St
Chicago, IL 60613-5974
Phone 7734726469267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00009364WAMDMental Health Counselor
149.017451ILMDSocial Worker
LCS 28549CAMDClinical Social Worker
28549CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Counseling Center PastSince Mar 2, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: centeronhalsted.swensoning@139261.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1063680650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135974",
            "telephone_number": "773-472-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135974",
            "telephone_number": "773-472-6469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Vale Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920845218",
            "country_code": "US",
            "telephone_number": "760-631-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "ING",
        "middle_name": "ERIK",
        "credential": "LCSW, CRADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW00009364",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 28549",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.017451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.